Handbook of Eating Disorders: Physiology, Psychology, and Treatment of Obesity, Anorexia, and Bulimia

By Kelly D. Brownell; John P. Foreyt | Go to book overview

20
Bulimia: Theories of
Etiology

W. Stewart Agras

Betty G. Kirkley

The recent emergence of bulimia as a well-defined and prevalent syndrome1,6 has led to much speculation and investigation regarding its etiology. While binge eating is often found in obesity and anorexia nervosa, this chapter will focus on bulimia proper, as defined in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III). Theories of the disorder's causation have ranged from the purely sociobehavioral to the purely biological. While there is some empirical evidence for both views, neither has emerged as the definitive explanation of why so many young women binge eat, induce vomiting, and/or abuse purgatives. This chapter reviews the evidence for both sociobehavioral and biological theories of etiology and discusses possible avenues for interaction between the two viewpoints.


Sociobehavioral Theories

From a sociobehavioral perspective, bulimia may be viewed as a deficit in self-regulation that has its inception in an extreme desire for thinness. According to this model, the young woman's desire to lose weight and be thin leads her to restrain her eating by dieting. This pattern of restrained eating may result in a state of real or perceived deprivation that

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